Diagnostic value of multi-slice CT for adult non traumatic acute abdomen / 中华放射学杂志

ABSTRACT

Objective To investigate the value of MSCT and its reconstruction technique for etiological factors of adult non traumatic acute abdomen.Methods The CT findings and clinical data of 1 632 adult patients with non traumatic acute abdomen confirmed by clinical treatment or pathological examination from July 2007 to June 2013 were retrospectively analyzed.Six hundred and sixty-four patients underwent plain scan and 968 patients underwent plain and enhanced scan.We observed MSCT manifestations of acute abdomen , calculated the accurate rate of diagnosis , and analyzed causes of missed diagnosis or misdiagnosis.Results CT diagnosis of 1 580 cases were entirely or partially consistent with the final results in 1 632 cases.Overall accuracy rate was 96.8%.Misdiagnosis or missed diagnosis accounted for 3.2% ( 52/1 632 ).The corresponding accuracy rates using CT with various etiology were urinary system stones 100.0% ( 293/293 ) , appendicitis 99.3% ( 278/280 ) , abdominal tumors 98.3%(227/231), cholecystitis and cholelithiasis 96.4% (213/221), acute pancreatitis 95.8% (159/166), intestinal adhesion 92.6%(100/108), gastrointestinal perforation 97.9%(92/94), internal and external hernia 95.2% ( 59/62 ) , intussusceptions 95.4% ( 42/44 ) , volvulus 91.7% ( 33/36 ) , foreign bodies 95.6%(22/23), ectopic pregnancy 92.3%(12/13), vascular disease 100.0% (16/16), inflammatory bowel disease 77.8%(7/9), and other diseases 75.0%(27/36).The main cause of missed diagnosis was the absence of obvious morphologic changes at early stage of the diseases.Atypical MSCT features resulted in misdiagnosis.Conclusion MSCT is a valuable tool in diagnosing adult non traumatic acute abdomen and its etiology.